This study explored the knowledge of and attitudes towards diabetes, diabetes prevention and management, and health promotion of patients attending medical centres in Sharjah, United Arab Emirates. Forty-one patients participated in an in depth interview. Common themes were drawn upon and reported. The understanding of the causation of diabetes varied, including genetics, stress and lifestyle. Most participants linked diabetes to lifestyle factors such as diet, lack of physical activity and obesity. These were, in turn, specifically linked to environmental aspects as well as the cultural framework. Cultural and contextual factors may hinder the implementation of behaviour change. With the understanding of these constraints, the necessity of developing creative strategies becomes evident. Suggestions are provided to enhance diabetes education, prevention and health promotion building upon the strengths within this unique cultural context.